License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials including but not limited to CGS fee schedules, general communications, Part B Medicare Bulletin, and related materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA website

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

AMA Disclaimer of Warranties and Liabilities.

CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a fourth party beneficiary to this Agreement.

CMS Disclaimer

The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

This license will terminate upon notice to you if you violate the terms of this license. The AMA is a fourth party beneficiary to this license.

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED "I ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.

IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "I DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN.

IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.

Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT-4 only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT-4 is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT-4. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. License to use CDT-4 for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association website

Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government use. Please click here to see all U.S. Government Rights Provisions.

ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT-4 is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CDT-4. The ADA does not directly or indirectly practice medicine or dispense dental services. The sole responsibility for the software, including any CDT-4 and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a fourth-party beneficiary to this Agreement.

CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT-4 should be addressed to the ADA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT-4. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled "I ACCEPT". If you do not agree to the terms and conditions, you may not access or use the software. Instead, you must click below on the button labeled "I DO NOT ACCEPT" and exit from this computer screen.

HIGLAS

**HIGLAS Video *NEW***

The HIGLAS video summarizes CGS’ transition from the DME Shared System to the Healthcare Integrated General Ledger Accounting System (HIGLAS) financial accounting system.

Higlas Video Transcript

If you would prefer to watch on YouTube, click here.

HIGLAS Letters

La versión en español de este comunicado se encuentra a continuación

As a DMEPOS supplier you received a letter from CGS Jurisdiction C regarding Medicare payment system changes. A copy of the letter you received is here.

In summary of the letter, effective February 14, 2020, Jurisdiction C will transition our financial accounting system from the DME Shared System (VMS) to the Healthcare Integrated General Ledger Accounting System (HIGLAS). The DME MAC will continue to use VMS for claim processing activities. Suppliers will continue to file claims and appeals as they do today. Please continue to submit claims and appeal requests as normal.

As we prepare for the HIGLAS transition, the Centers for Medicare and Medicaid Services (CMS) approved a temporary waiver of the claims processing payment floor for paper and electronic claims.

What does this all mean to suppliers?

On February 11, 2020, the payment floor will be reduced to 7 days for electronic clams and 14 days for paper claims.
On February 12, 2020, the payment floor will be reduced to zero days for electronic and paper claims and payments will be released for claims that have already been approved for payment.
The temporary reduction of the payment floor will result in payments being issued early. This may give the appearance that your cash revenues have increased but your claims may have simply paid earlier than usual.
Following the Jurisdiction C transition to HIGLAS, CGS will resume normal cycles on February 18, 2020.
Payments will not be issued February 17-19, 2020.
Suppliers will experience a temporary gap in most payment activity because most claims will have been paid early due to the temporary payment floor reductions.
As we transition, there is potential for temporary interrupts in the financial information available on the Interactive Voice Response (IVR), the myCGS web portal, and online remittance advices.
There will be some visual changes to remittance advices and demand letters after transition. The changes to the visual appearance of the remittance advices and demand letters will be permanent.
After transitioning to HIGLAS, when two or more suppliers are affiliated and have the same Tax Identification Number (TIN), payments may be withheld from one supplier to collect another supplier’s overpayments. Overpayment collections from affiliated suppliers will begin once HIGLAS is implemented.

CGS is committed to keeping suppliers informed of the HIGLAS implementation. The aforementioned dates are subject to change. Updated information regarding HIGLAS will be provided on this site.

Como proveedor de DMEPOS, usted recibió una carta de parte de CGS Jurisdicción C acerca de los cambios en el sistema de pago de Medicare.La copia de la carta que recibió está aquí.

En resumen la carta menciona que efectivo Febrero 14, 2020 la Jurisdicción C hará la transición del actual sistema financiero contable “DME Shared System (VMS)” al “Healthcare Integrated General Ledger Accounting System (HIGLAS)”. El DME MAC continuará con el uso del VMS para las actividades de procesamiento de reclamaciones. Los proveedores continuarán enviando reclamaciones y apelaciones igual a como lo hacen hoy. Por favor continúe enviando las reclamaciones y apelaciones normalmente.

Mientras nos preparamos para la transición a HIGLAS, los Centros de Servicio de Medicare y Medicaid (CMS) aprobaron una excepción temporal de las reclamaciones en papel y electrónicas en proceso en el piso de pago.

Que significa esto para los proveedores?

En Febrero 11, 2020, el piso de pago será reducido a 7 dias para las reclamaciones electrónicas y 14 dias para las reclamaciones en papel.
En Febrero 12, 2020 el piso de pago será reducido a cero dias para las reclamaciones electrónicas y en papel y se liberarán los pagos de las reclamaciones que ya hayan sido aprobadas para pago.
La reducción temporal del piso de pago tendrá como resultado que las reclamaciones se paguen mas temprano. Esto puede dar la apariencia de que sus ingresos en efectivo han aumentado, pero lo que sucede es simplemente que sus reclamaciones se han pagado antes de lo usual.
Después de la transición de la Jurisdicción C a HIGLAS, CGS reanudará los ciclos normales en Febrero 18, 2020.
No se harán pagos en Febrero 17-19, 2020.
Los proveedores experimentarán una interrupción temporal de la mayoría de la actividad de pago debido a que la mayoría de las reclamaciones habrán sido pagadas antes como consecuencia de la reducción temporal del piso de pago.
Mientras hacemos la transición, existe el potencial de interrupciones temporales en la disponibilidad de la información financiera en el Sistema Interactivo de Voz (IVR), el portal de myCGS y las notificaciones de la remesa en línea.
Después de la transición, habrán algunos cambios visuales en las notificaciones de la remesa y en las cartas de solicitud. Los cambios en la apariencia visual de las notificaciones de la remesa y de las cartas de solicitud, serán permanentes.
Después de la transición a HIGLAS, cuando dos o mas suplidores están afiliados y tienen el mismo Número de Identificación de Impuestos (TIN), los pagos de un suplidor pueden ser retenidos para recaudar los sobrepagos del otro suplidor. El recaudo de los sobrepagos de los suplidores afiliados comenzará una vez que HIGLAS sea implementado.

CGS está comprometido a mantener a los suplidores informados acerca de la implementación de HIGLAS. Las fechas mencionadas anteriormente están sujetas a cambio. La información actualizada acerca de HIGLAS se brindará en este sito.

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